AFP Clinical Answers
Colorectal Cancer Screening, Breastfeeding, Miscarriage, Eczema, Routine Screening for Children
Am Fam Physician. 2020 Mar 1;101(5):270.
Is flexible sigmoidoscopy better than fecal occult blood testing for colorectal cancer screening in adults?
Although both are effective at reducing colorectal cancer mortality, flexible sigmoidoscopy appears to reduce colorectal cancer mortality more than guaiac-based fecal occult blood testing (FOBT). Flexible sigmoidoscopy is not clearly superior because the two methods have not been directly compared. Screening with flexible sigmoidoscopy prevented one death for every 450 asymptomatic adults screened compared with one death prevented for every 900 asymptomatic adults screened with FOBT. Both methods had similar harms of bleeding, perforation, or death related to follow-up colonoscopy or surgery. The number needed to harm was one in 1,250 for flexible sigmoidoscopy and one in 3,300 for FOBT.
Does skin-to-skin-contact in healthy, vigorous newborns improve the duration of breastfeeding in lactating mothers?
Skin-to-skin-contact in the immediate postnatal period should be recommended to all mothers because it is associated with a higher likelihood of exclusive breastfeeding at hospital discharge and for up to six months afterward (number needed to treat = 5 to 8).
What is the advantage of progestin therapy for recurrent miscarriage?
For one-half of women with recurrent spontaneous abortion, defined as three or more miscarriages, no cause can be found. A Cochrane review showed that with early progestin therapy, an additional one in 15 pregnant women did not have a spontaneous abortion, one in 10 went on to have a live birth, and one in 20 avoided preterm labor. Despite these positive outcomes, the studies were limited by heterogeneity and poor control of inclusion criteria. Also, progestin therapy had to be started very early, before many patients would recognize a pregnancy.
Does bath oil improve eczema symptoms in children?
Bath oil does not improve eczema symptoms in children, based on a large randomized controlled trial in the United Kingdom.
What screening is recommended in routine visits for school-aged children?
School-aged children should be screened for obesity by measuring body mass index. Those with obesity (i.e., body mass index at or above the 95th percentile) should be offered resources and referral for comprehensive, intensive behavioral interventions. The American Academy of Pediatrics recommends annual blood pressure measurements in school-aged children, or at every health care encounter in those who have risk factors, but the U.S. Preventive Services Task Force found insufficient evidence to assess the benefits and harms of universal blood pressure screening.
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